11x
Return on Investment
35% to 55%
Reduction in Admin Expense
100%
increase in Efficiency
RAQ +
Smart Risk Adjustment in Value Based Care
RAQ+ is an AI-powered platform designed to empower healthcare providers to achieve comprehensive success across revenue integrity, quality improvement, and health equity. By leveraging cutting-edge technology and deep domain expertise, Bulwark Health delivers a VBC platform that enables you to:
Outpatient Clinical Document Integrity
Analyze undercoding and overcoding risks in real-time for compliant and accurate RAF scores
Generate compliant queries for accurate HCC recapture
Validate HCCs Concurrently
Reduce RADV audit risk through real-time HCC validation
Ensure compliance with CMS guidelines for accurate risk adjustment
Mapping & Categorization
Mapping algorithms categorize extracted codes into Hierarchical Condition Categories (HCCs)
Flags codes requiring further validation based on predefined rules and predictive modeling
Advanced Analytics & Risk Scoring
Detects, prioritizes and mitigates coding outliers and patterns indicative of potential issues such as:
- Diagnostic Upcoding
- Nonspecific codes
- Unsupported HCC assignments
Advanced analytics to highlight gaps in evidence across clinical notes, labs, and imaging to corroborate coded conditions.
Uncover and Document HCCs:
Identify new and chronic condition diagnosis codes (HCCs) with unparalleled accuracy.
Streamline documentation through outpatient CDI processes for efficient HCC capture.
Engage Providers at the Point of Care
Bridge the gap between care gaps and HCC capture through point-of-care provider engagement.
Drive better clinical outcomes and optimize risk scores.
User Interface & Audit Tools
User-friendly interface for Auditors
- RAF Score re-capture across providers
- RADV Audit Prep made easy
- Robust outpatient CDI Process
Dashboards and Smart Reports
- Provider Score Cards
- RAF Scores across all lines of business
- Real time RAF score trending
- Quality re-capture Score Cards
Boost Star Ratings
Leverage data-driven insights to target timely and effective provider and member engagement.
Improve care quality and drive higher Star ratings for program recognition.
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